POS1071 THE IMPACT OF COMORBIDITIES ON THE EFFICACY OF IL-6 INHIBITOR OLOKIZUMAB COMPARED TO ADALIMUMAB
Authors: E. Feist, M. E. Luggen, E. Nasonov, S. Yakushin, D. Bukhanova, A. Egorova, S. Grishin, M. Samsonov, J. S. Smolen
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Comorbid conditions may affect efficacy of treatment in patients with rheumatoid arthritis (RA). <h3>Objectives</h3> The aim of this analysis was to evaluate the impact of comorbidity burden on the efficacy of IL-6 inhibitor olokizumab (OKZ) and TNF-α inhibitor adalimumab (ADA) in the CREDO-2 clinical trial cohort of patients with active rheumatoid arthritis (RA). <h3>Methods</h3> Patients in the double-blind RCT (NCT02760407) who received OKZ 64 mg once every 2 weeks (q2w) or 4 weeks (q4w), or ADA 40mg q2w for 24 weeks were included. To assess the impact of comorbid conditions on efficacy, outcomes were stratified by patients with Low Charlson Comorbidity Index (CCI = 1; RA only) vs High (CCI ≥ 2; RA and at least 1 comorbidity). Age points in CCI were excluded from the analysis. The comparison of outcomes between the Low and the High CCI groups was performed using χ2-test in unadjusted analysis, and logistic regression in adjusted analysis. Baseline characteristics with an absolute standardized difference &gt; 0.1 were identified as covariates for adjusted comparison. The impact of comorbidity was investigated separately for OKZ and ADA. <h3>Results</h3> A total of 1402 patients with RA were included in the analysis: 940 patients treated with OKZ 64 mg q2w or q4w and 462 patients treated with ADA 40mg q2w. All patients received background MTX therapy. The results are presented in the Table 1. There was no difference in efficacy results between the OKZ-treated groups with and without comorbid conditions during the study, except the achievement of SDAI ≤ 3.3 at Week 24, which was observed more frequently in the Low CCI group. However, the presence of comorbid conditions affected the efficacy of ADA therapy. In the group of High CCI, the proportions of patients who achieved ACR 20 response at Week 12, ACR 50 response (Weeks 12 and 24), SDAI ≤ 3.3 (Weeks 12 and 24) and CDAI ≤ 2.8 (Week 24) and CDAI ≤ 10 (Week 24) were significantly lower in comparison with the group of Low CCI. <h3>Conclusion</h3> High CCI (or presence of at least one comorbid disease) does not affect OKZ treatment efficacy in RA patients. In the same study, high CCI significantly reduces the efficacy of ADA treatment, including LDA and remission achievement. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> Eugen Feist Consultant of: Abbvie, Eli Lilly, Galapagos, Medac, Novartis, Sanofi, Sobi, R-Pharm, Grant/research support from: Eli Lilly, Novartis, Pfizer, Michael E Luggen Grant/research support from: Abbvie, Biogen, GSK, Lilly, R-Pharm, Sun Pharma, UCB, Evgeny Nasonov Consultant of: AbbVie, Eli Lilly, Janssen, Novartis, Pfizer, Sergey Yakushin Consultant of: Servier, Bayer, Sanofi, Behringer, Gedeon Richter, AstraZeneca, Grant/research support from: Servier, Bayer, Sanofi, Behringer, Gedeon Richter, AstraZeneca, Gilead, Gexal AG, Novartis, Genzyme Corp., Roche, GlaxoSmithKlein(GSK), Eli Lilly, R-Pharm, Daria Bukhanova Employee of: R-Pharm, Alina Egorova Employee of: R-Pharm, Sergey Grishin Employee of: R-Pharm, Mikhail Samsonov Employee of: R-Pharm, Josef S. Smolen Consultant of: AbbVie, BMS, Celgene, Chugai, Eli Lilly, Gilead, Janssen, MSD, Novartis-Sandoz, Pfizer, Roche, Samsung, Sanofi, UCB, Grant/research support from: AbbVie, BMS, Celgene, Chugai, Eli Lilly, Gilead, Janssen, MSD, Novartis-Sandoz, Pfizer, Roche, Samsung, Sanofi, and UCB.